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INTRODUCTION: Erich arch bar used for maxillomandibular fixation (MMF) since decades has several disadvantages such as risks of injury, additional operating room time, and gingival trauma. To overcome these downsides, modified Erich arch bar was introduced; however, there is not much available literature, indicating the efficacy of modified Erich arch bar over that of conventional arch bar wire. Therefore, the present study focuses on comparing efficiency of modified arch bar with conventional arch bar. MATERIALS AND METHODS: This comparative randomized study was conducted on 32 patients that required MMF and were divided into Group A patients who received intermaxillary fixation (IMF) with modified Erich arch bars and Group B patients with conventional Erich arch bars. The parameters recorded were average surgical time required, wire prick injuries, IMF stability, occlusal stability, screw loosening, oral hygiene status, and vitality response of the teeth. The variables were statistically analyzed using Student's t-test and Wilcoxon signed-rank test. RESULTS: The wire prick injury, intraoperative time noted in Group A was significantly reduced in comparison to Group B (P < 0.0001). Debris indices were significantly good in Group A in comparison to Group B (P < 0.0001). Nonvitality response of tooth was significantly more in Group B than in Group A patients (P < 0.05). DISCUSSION: The efficiency of modified Erich arch bar group was superior to the conventional arch bar with very limited restrictions.
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INTRODUCTION: Of the many chronic painful conditions, trigeminal neuralgia (TN) affecting the orofacial region needs the particular attention of physicians and surgeons, especially those specialising in the maxillofacial region. Treatment protocols for the management of classic TN include pharmacology and surgical intervention. Oral and maxillofacial surgeons have traditionally employed the peripheral neurectomy in the surgical management of TN. This review aims to evaluate the efficacy of peripheral neurectomy in the management of TN with regard to (a) the relief of symptoms in comparison with standard neurosurgical procedures and (b) the duration of pain relief and complications observed compared to standard neurosurgical procedures. METHODS: The review of the literature was done according to PRISMA guidelines and included randomised controlled trials, reviews and prospective clinical studies involving surgical procedures for the management of TN. The primary outcomes evaluated were (a) initial relief of pain, (b) duration of relief of pain, (c) complications observed with ablative procedures and (d) recurrence of symptoms. A total of 43 studies fulfilled the inclusion criteria. RESULTS: In a total of 7913 patients from the 43 studies, central procedures were found to have best results for both quality and duration of pain relief. Percutaneous and peripheral procedures were associated with increased recurrence rates. The consolidated rates of complication for peripheral, percutaneous and central procedures were 39.46, 65.42 and 10.41%, respectively. The use of peripheral neurectomy alone in the management of classic TN was observed in 10 studies. CONCLUSION: Peripheral neurectomy in TN is associated with lesser quality of pain relief in comparison with central neurosurgical procedures. It also provides only short- to medium-term pain relief. Most studies with the use of peripheral neurectomy involved only a small group of patients with short follow-up periods. Oral and maxillofacial surgeons must not consider the peripheral neurectomy as the first surgical option in the management of classic TN. Long-term results can be achieved better with appropriate central neurosurgical procedures and pharmacotherapy.
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INTRODUCTION: Lingual nerve damage is one of the common complications following mandibular third molar surgery. On considering the impact of lingual nerve damage on the patient's quality of life, it is necessary to exercise caution to minimize its occurrence. MATERIAL AND METHODS: Although many lingual retractors are available, in this article we describe an indigenously designed lingual retractor for use in mandibular third molar surgery. CONCLUSION: The indigenous lingual retractor described in this article provides advantages like clear access and excellent retention unlike conventional retractors.
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OBJECTIVES: To compare the effectiveness of bupivacaine with adrenaline with that of carbonated bupivacaine with adrenaline on pain, onset of anesthesia and duration of anesthesia following surgical removal of impacted mandibular third molar. STUDY DESIGN: All the patients who underwent surgical removal of impacted mandibular third molar and who fulfilled our inclusion and exclusion criteria from 1st June 2013 to 30th June 2014 were included in our study. Patients who were diagnosed as having impacted mandibular third molar were randomly allocated to two groups namely group A (bupivacaine with adrenaline), group B (carbonated bupivacaine with adrenaline). Pain during deposition of local anesthetic, onset of anesthesia and duration of anesthesia were compared between the two groups. The collected data were subjected to statistical analysis by Chi Square test, Mann-Whitney U test. RESULTS AND CONCLUSION: The efficacy of carbonated bupivacaine with adrenaline is more compared with bupivacaine with adrenaline in decreasing pain on deposition of local anesthetic solution and in rapid onset of anesthesia. The duration of anesthesia for carbonated bupivacaine with adrenaline and bupivacaine with adrenaline had no significant difference. The use of carbonated bupivacaine with adrenaline will reduce the patient discomfort both intra-operatively and post-operatively.
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Osteoma is a slow growing benign tumor consisting of well differentiated compact or cancellous bone that increases in size by continuous growth. It can be of a central, peripheral, or extraskeletal type. The peripheral type arises from the periosteum and is rarely seen in mandible. Although completely curable with adequate surgical treatment, osteomas precede the clinical radiographic evidence of colonic polyposis/Gardner's syndrome. Therefore they may be sensitive markers for the disease. Recurrence of peripheral osteoma after surgical excision is extremely rare. However it is appropriate to provide both clinical and radiographic follow up after surgical excision of peripheral osteoma. This article describes the case of a 45 year old male who presented with painless swelling of the right body of mandible and resultant cosmetic facial disfigurement and functional impairment.
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Eosinophilic angiocentric fibrosis (EAF) is a rare fibroinflammatory disorder with a predilection for upper respiratory tract submucosa. We report a 45-year-old man with progressive unilateral visual loss secondary to a retroorbital soft tissue mass with histological features consistent with EAF. The patient experienced marked improvement in vision after endoscopic optic nerve decompression through sphenoethmoidectomy.
Subject(s)
Granuloma, Respiratory Tract/complications , Optic Nerve Diseases/physiopathology , Decompression, Surgical , Disease Progression , Fibrosis , Humans , Male , Middle Aged , Tomography Scanners, X-Ray ComputedABSTRACT
The purpose of this study is to develop and validate a simple, sensitive, and robust high-performance liquid chromagraphic (HPLC) method for the determination of impurities ca. 2-methyl-2-propyl-1,3-propane diol (MP0) and 2-hydroxymethyl-2-methyl pentyl carbamate (MP1) in meprobamate (MEP) drug substance with refractive index (RI) detection. This method utilizes a Zorbax Eclipse XDB C(18) HPLC column, a mobile phase of 80:20 (v/v) 10 mM KH(2)PO(4),-acetonitrile, respectively. The stability-indicating capability of the method has been established by performing stress studies under acidic, basic, oxidation, light, humidity, and thermal conditions. The major degradation products of acid and base hydrolysis are identified as MP0 and MP1. The recovery data obtained for impurities are between 96.0-109.8%. The detection and quantitation limits of this method ranges from 0.009 to 0.017 mg/mL and 0.029 to 0.055 mg/mL, respectively. The relative standard deviation (RSD) for the area at QL is less than 6.1%. Good linearity (r(2) > 0.99) and precision (RSD < 2.2%) have been obtained for MEP, MP0, and MP1. This method has been applied successfully to determine the content of impurities in MEP bulk drug.
